M1 Medulloblastoma: high risk at any age.

Authors :: Sanders RP
Onar A
Boyett JM
Broniscer A
Morris EB
Qaddoumi I
Armstrong GT
Boop FA
Sanford RA
Kun LE
Merchant TE
Gajjar A
Source :: Journal of neuro-oncology [J Neurooncol] 2008 Dec; Vol. 90 (3), pp. 351-5. Date of Electronic Publication: 2008 Aug 15.
Publication Year :: 2008
Abstract: Background: The prognosis for children with M1 medulloblastoma (positive CSF cytology) has not been well-defined.<br />Methods: We retrospectively reviewed the records of 285 newly diagnosed medulloblastoma patients treated between 1984 and 2006. Older children received post-operative craniospinal and tumor bed irradiation; radiotherapy for younger children depended on treatment era and physician/family preference.<br />Results: 55 patients were <3 years old and 230 patients were >or= 3 years old at diagnosis. We detected significant (P < 0.0001) associations between M1 disease and EFS for the entire cohort and for both younger and older patients. Among younger children, M1 patients had lower EFS than M0 (P = 0.0044).<br />Conclusions: Children <3 years old with M1 medulloblastoma fared poorly in our small series. Survival for older children with M1 disease treated with higher-dose CSI was better than that of M2/M3 patients, but still less than optimal; our findings do not support reduction in therapy for either cohort.